Guam Memorial Hospital's longstanding financial problems are clearly evident, but so is the need for elected officials to ensure it has the resources it requires to meet its legal mandates.

As of Oct. 22, the hospital owed vendors almost $24 million, and that debt could affect patient care if vendors decide to stop providing needed services and supplies. But the hospital also is owed about $235 million and is unlikely to recoup the vast majority of that; about $166.4 million of that is owed by self-paying patients, which refers to patients who lack health insurance.

That debt is so high because federal law requires the hospital to treat emergency patients regardless of their ability to pay.

Of that $166.4 million, about $35.7 million was classified as current accounts receivable, while patients from the freely associated states of Micronesia owed about $6 million. Collection agencies are trying to collect more than $50.5 million and the Department of Revenue and Taxation is supposed to garnish about $74 million. But how do you collect money from people who have none? How do you garnish tax rebates from people who don't work or don't get tax rebates?

Over the years, local elected officials have said the hospital needs to improve its collections and reduce its costs, and that continues to be their attitude. But while the hospital certainly can and must tighten its financial controls and work to improve collections, doing so won't make up for the millions upon millions of dollars it's owed and will be owed by future self-pay patients.

The hospital can't increase the rates and fees to make up the money it loses by following the law that requires it to treat every patient in need. Doing so would make health care prohibitively expensive. Even patients with insurance wouldn't be able to afford hospital care.

Elected officials need to wake up to the reality that the hospital's financial condition is untenable unless it gets more support and resources. That includes ensuring local agencies and the federal government pay what they owe the hospital -- more than $4.3 million as of Aug. 31, including $2.7 million owed by the Department of Corrections, and more than $700,00 owed by the Department of Mental Health and Substance Abuse.